The effectiveness of active population screening and treatment for sleeping sickness control in the Democratic Republic of Congo
The effectiveness of active population screening and treatment for sleeping sickness control in the Democratic Republic of Congo
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DOI：
10.1111/j.1365-3156.2004.01240.x
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发表时间：
2004-05-01
影响因子：
3.3
通讯作者：
Boelaert, M
中科院分区：
文献类型：
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作者：
Robays, J;Bilengue, MMC;Boelaert, M
背景刚果民主共和国(DRC)人类非洲锥虫病(HAT)控制方案使用锥虫卡片凝集试验(CATT)进行大规模筛查。我们观察了CATT和改进的寄生虫学确认对筛查和治疗有效性的贡献。方法筛查和治疗过程的有效性通过单轮筛查后有效治愈的HAT病例的百分比来衡量。这一过程分为五个步骤进行分析：(1)筛查的出席率；(2)筛查程序的敏感性；(3)寄生虫学确认的敏感性；(4)确诊病例有效接受治疗的比例；(5)治疗的治愈率。我们使用了一个简化的模型，该模型将经历每一步的感染者的比例乘以。我们结合国家管制方案在1997年1月至1998年12月期间收集的常规数据和公布的数据估计了这些参数。对于不同的就诊率，我们比较了基于GATT或基于CATT结合改进的微型阴离子交换柱寄生虫学确认(MAECT)的筛查策略与以前使用的仅基于颈部腺体触诊和显微镜的筛查策略的有效性。结果模型显示，主动病例发现和治疗策略的总体有效性为
BACKGROUND The human African trypanosomiasis (HAT) control programme of the Democratic Republic of Congo (DRC) uses mass screening with the card agglutination test for trypanosomes (CATT). We looked at the contribution of CATT and improved parasitological confirmation to the effectiveness of screening and treatment.METHOD The effectiveness of the screening and treatment process is measured by the percentage of HAT cases that is effectively cured after a single round of screening. The process is analysed in five steps: (i) the attendance at the screening, (ii) the sensitivity of the screening procedure, (iii) the sensitivity of the parasitological confirmation, (iv) the proportion of the confirmed cases that effectively receive treatment and (v) the cure rate of the treatment. We used a simplified model that multiplies proportions of infected persons that go through each step. We estimated these parameters using a combination of routine data collected by the national control programme over the period January 1997 to December 1998 and published data. For varying attendance rates we compared the effectiveness of screening strategies based on GATT or on CATT combined with improved parasitological confirmation by mini anion exchange column technique (mAECT) with the previously used strategy based on palpation of neck glands and microscopy alone.RESULTS The model shows that overall effectiveness of the active case detection and treatment strategy is